Laserfiche WebLink
. � �1��' <br /> Please check one: New � Addition <br /> JOB SITE <br /> Owner's Name o � � 6 �-�.�.� 0 Telephone Number <br /> Mailing Address � S(��SS �. <br /> Sprinkler Contractor's Name N'�e Sed v i c�, � Telephone Number s.3 S-�� �� <br /> Contact Person Q.a r �G ✓� C,.- � <br /> Mailing Address '�I�.3� 5 �u/��-�(n � `��, � <br /> WATER SUPPLY � <br /> Lake Well � City <br /> BACKFLOW DEVICE <br /> AVB PVB � RPZ <br /> Year of <br /> Make Model Manufacture uantit <br /> S rinklers c�tt� �U O /9 -� <br /> TOTAL <br /> HYDRAULIC CALCUI.ATIONS Design Data: <br /> Area of Application: �(f 2f� Sq. Ft. <br /> Coverage per Sprinkler: SC� � Sq. Ft. <br /> No. of Sprinklers: � . � /O�\� <br /> Total Water Required: es� �� � �0 GPM b <br /> PERMIT FEE CALCULATION <br /> 1. Permit Fee $ 35.00 <br /> 2. State Surchar�e. $ .50 <br /> 3. Mail-In Fee $ 1.50 <br /> 4. TOTAL PERMIT F'EE (Add lines 1-3 above) $ <br /> The undersigned hereby applies to the City for issuance of a Sprinkler System Permit, agrees <br /> to do all work in strict accordance with the ordinances of the Ciry and State regulations, and <br /> certifies that all statements made on this application are complete, true and correct. <br /> . � ����.�- <br /> Applicant Date <br /> *�*�**�* *************** ** **********�**x�*x�****�******�***�****�************ <br /> Approved Approved with Corrections Denied <br /> Reviewed by: <br /> Date <br />